By Mary Stover, CFCC Student Fellow (2016-2017)<\/p>\n
On a recent Wednesday I, along with other CFCC Student Fellows, observed an uplifting morning in the Adult Drug Treatment Court at the Baltimore City District Court.\u00a0 At the conclusion of each of seven brief status hearings, the presiding judge, the Honorable Martin Dorsey, congratulated the compliant participant, calling him or her a member of the \u201cA team.\u201d We all applauded seven times.\u00a0 Even in the two non-compliant participants\u2019 cases, the status hearings appeared collaborative and governed by therapeutic justice.\u00a0 In short, we observed a problem-solving court in action.<\/p>\n
Nevertheless, while many drug court programs — which combine mandated treatment and close judicial oversight — have been found to be more effective at combating drug use and criminal recidivism than traditional incarceration and probation,[1]<\/a> they are not a panacea.[2]<\/a>\u00a0 In 2014-2015, nearly half of Maryland\u2019s 885 drug court participants did not graduate from the program,[3]<\/a> consistent with drug court program failure rates of 40 to 64 percent across the country.[4]<\/a> \u00a0Research on post-program results is mixed and suggests that the positive impact of participation in a drug court program may not be long-term in a significant number of cases.[5]<\/a>\u00a0 A study of Baltimore\u2019s adult drug court program indicates that over 78 percent of drug court participants had been arrested for a new offense within three years after program entry and re-arrest rates for participants had dwindled to a 10-point differential as compared to those who went through the traditional court process.[6]<\/a>\u00a0 Similar three-year differentials were found for self-reported drug and alcohol use.[7]<\/a> \u00a0The Baltimore researchers noted that, at three years after program entry, the positive effects of drug treatment court did not extend to other physical and mental health status indicators, family and social connections, or employment status.[8]<\/a><\/p>\n The drug treatment court\u2019s problem-solving approach seems more effective than incarceration and probation in addressing the reasons why an individual is involved with the criminal justice system.\u00a0 Why, then, are graduation rates and positive long-term effects not more pronounced?\u00a0 The proceedings that we observed last Wednesday morning and subsequent discussion with court personnel illuminated some of the roadblocks faced by drug court participants during and after completing the program.\u00a0 Increased access to appropriate, affordable housing stood out to me as a necessary, yet often missing, part of the solution.<\/p>\n Two of Wednesday\u2019s compliant participants alluded to their previous living situations when they commented on the need to \u201cget out of Baltimore\u201d in order to manage their addictions.\u00a0 I do not know from which aspects of their previous lives these individuals felt they needed to escape, but I do not think that moving is always advantageous.\u00a0 Some participants, such as a woman who noted the critical role that the support of her family had played in her success, may fare better when they remain close to positive family and community relations. \u00a0Regardless of whether participants prefer to stay in a supportive neighborhood or want to distance themselves from unhealthy personal relationships, widespread drug use in their neighborhoods, or other negative factors, they often need housing assistance.\u00a0 The Baltimore Drug Treatment Court coordinator confirmed that lack of access to housing, both during and after participation in the program, is one of the most substantial barriers to long-term success.<\/p>\n Housing and neighborhood conditions are generally known to affect people\u2019s mental and physical health.[9]<\/a>\u00a0 For drug court participants whose pre-treatment living situation was in close proximity to drug activity, research has shown \u201cthat moving away from drug-using friends and acquaintances supports the maintenance of abstinence.\u201d[10]<\/a>\u00a0 For all drug court participants, \u201cpermanent housing is associated with a reduction in recidivism.\u201d[11]<\/a>\u00a0 The drug court uses a holistic approach to identify and address participants\u2019 needs, including housing.\u00a0 But the Baltimore region, like many other areas in the U.S., suffers from an affordable housing crisis and concentrations of neighborhood disadvantages that disproportionately affect our most vulnerable populations, including drug court participants.[12]<\/a><\/p>\n The annual income needed to afford an average priced modest studio or a one-, two- or three-bedroom apartment in the Baltimore metropolitan region is $34,040, $41,320, $51,920 and $66,520, respectively.[13]<\/a>\u00a0 A minimum-wage worker would have to work at least 79 hours per week to afford a modest studio apartment in the Baltimore area.[14]<\/a>\u00a0 The drug court participant population typically \u201cis very low on the socioeconomic scale, and has a lower level of educational achievement compared to the general population.\u201d[15]<\/a>\u00a0 Even assuming optimistically that a drug court program graduate would be able to earn Baltimore City\u2019s estimated median renter income of $28,665, she or he would face a $6,375 annual housing affordability gap for a studio apartment.[16]<\/a> \u00a0\u00a0A program participant earning 30 percent or less of the median income faces a gap of at least $8,000.[17]<\/a><\/p>\n Baltimore City District Court Drug Treatment Court personnel are working with assisted housing providers and others to increase the court\u2019s ability to identify and secure supportive housing for participants during and after residential treatment.\u00a0 Housing assistance, however, is extremely scarce.\u00a0 Twenty-five thousand households in Baltimore City are on wait lists for federal housing assistance, where the wait can take as long as ten years.\u00a0 Another 50,000 households have applied but were turned away.[18]<\/a>\u00a0 Furthermore, drug court participants may be barred from some types of housing assistance because of their criminal records, and many landlords refuse to accept housing assistance vouchers.[19]<\/a>\u00a0 Without assistance, a program participant is unlikely to be able to rent decent housing anywhere in the region, let alone in a neighborhood that meets his or her needs.<\/p>\n Concluding on a hopeful note, very low-income Baltimoreans\u2019 access to housing may improve after tomorrow\u2019s election.\u00a0 Question J on the ballot asks whether the Baltimore City charter should be amended to establish an Affordable Housing Trust Fund, a legal mechanism that will allow the City Council and mayor to designate funds for housing assistance programs for \u201cthe city\u2019s neediest residents.\u201d [20]<\/a> \u00a0Once established, the trust fund would receive ongoing public funding to support the preservation and production of affordable housing units and services aimed at individuals and families at 50 percent or below the area median income (AMI), with most of the funding being targeted to those at 30 percent or below the AMI.[21]<\/a><\/p>\n Of course, housing assistance alone will not guarantee drug court participants\u2019 long-term success.\u00a0 For those who suffer from addiction, ongoing access to health-centered treatment seems to me to be the most important key to sustained recovery.\u00a0 My hope is that improved housing will provide an environment that optimizes the chances of continued treatment success for Baltimore\u2019s drug court participants.\u00a0 That is one of the reasons I plan to vote \u201cyes\u201d on Question J.<\/p>\n What barriers to success do you think drug court participants face?\u00a0 Do you think increased housing assistance would help?\u00a0 What do you think of Question J?<\/p>\n [1]<\/a> See<\/em> Randall T Brown, Systematic Review of the Impact of Adult Drug Treatment Courts<\/em>, 155 Translational research 263 (2010).\u00a0 See<\/em> also<\/em> Ojmarrh Mitchell et al., Assessing the effectiveness of drug courts on recidivism: A meta-analytic review of traditional and non-traditional drug courts<\/em>, 40 Journal of Criminal Justice 60 (2012), available at http:\/\/www.courtinnovation.org\/sites\/default\/files\/documents\/Assessing_Efectiveness.pdf.<\/p>\n [2]<\/a> For a critical review of drug courts and drug court research from a health policy perspective see Drug Policy Alliance, Drug Courts Are Not the Answer: Toward a Health-Centered Approach to Drug Use<\/em> (March 2011), available at https:\/\/www.drugpolicy.org\/docUploads\/Drug_Courts_Are_Not_the_Answer_Final2.pdf.<\/p>\n [3]<\/a> Kathleen Seifert, Review of Problem-Solving Courts in Maryland<\/em>, Sayra and Neil Meyerhoff Center for Families, Children and the Courts (Oct. 18, 2016), https:\/\/ubaltlawcfcc.wordpress.com\/2016\/10\/18\/review-of-problem-solving-courts-in-maryland\/.<\/p>\n [4]<\/a> See Mitchell, supra<\/em> note 1, at 61.<\/p>\n [5]<\/a> Christopher P. Krebs et al., Assessing the Long-Term Impact of Drug Court Participation on Recidivism with Generalized Estimating Equations<\/em>, 91 Drug and Alcohol Dependence 57 (2007).\u00a0 A 2005 GAO review of recidivism identified 17 drug courts for which post-program recidivism was analyzed. \u201cFor the 9 drug court programs reporting significant reductions, the differences in reconviction rates between drug court participants and comparison group members ranged from 5 to 25 percentage points.\u201d U.S. Gov\u2019t Accountability Office, GAO-05-219, Adult Drug Courts: Evidence Indicates Recidivism Reductions and Mixed Results for Other Outcomes, 52 (2005), available at http:\/\/www.gao.gov\/new.items\/d05219.pdf<\/a>.<\/p>\n [6]<\/a>\u00a0 Denise Gottfredson et al. The Baltimore City Drug Court: 3-Year Self-Report Outcome Study<\/em>, Evaluation Review, February 2005, at 42, 47, available at https:\/\/ccjs.umd.edu\/sites\/ccjs.umd.edu\/files\/pubs\/Gottfredson2005.pdf.<\/p>\n [7]<\/a> See id.<\/em> at 52-58. The researchers urge caution in interpreting differentials between drug court and regular court outcomes unambiguously as true treatment effects because of differences in pretreatment characteristics.<\/p>\n [8]<\/a> Id.<\/em> at 61.<\/p>\n [9]<\/a> See e.g., <\/em>Center on Social Disparities in Health at the University of California at San Francisco and the Build Healthy Places Network, Making the Case for Linking Community Development and Health, 6 (2015), available at http:\/\/www.phi.org\/resources\/?resource=making-the-case-for-linking-community-development-and-health<\/a> (\u201cA large body of literature has linked different kinds of conditions in neighborhoods with health; these include physical conditions, the services available and social conditions\u201d). Living in a disadvantaged neighborhood (i.e., a neighborhood with high rates of poverty, female-headed households, unemployment and public assistance recipients) has been found to have a positive relationship with drug use, regardless of individual-level socioeconomic status.\u00a0 Causation, however, is unclear.\u00a0 See <\/em>Jason D. Boardman et al., Neighborhood Disadvantage, Stress, and Drug Use among Adults<\/em>, 42 Journal of Health and Social Behavior 151 (2001).<\/p>\n [10]<\/a> Ciska Wittouck et al., The Impact of Drug Treatment Courts on Recovery: A Systematic Review<\/em>, The Scientific World Journal, at 1, 10 (2013), available at https:\/\/www.hindawi.com\/journals\/tswj\/2013\/493679\/.<\/p>\n [11]<\/a> Id<\/em>.<\/p>\n [12]<\/a> See e.g., <\/em>Center on Social Disparities in Health at the University of California at San Francisco and the Build Healthy Places Network, supra<\/em> note 9 (\u201cHealthy and unhealthy neighborhood conditions are not distributed randomly. Extensive research shows that low-income and minority neighborhoods are more likely to experience harmful conditions and to lack health-promoting conditions\u201d).\u00a0 See also e.g.,<\/em> Alan Berube and Brad McDearman, Good fortune, dire poverty, and inequality in Baltimore: An American story<\/em>, The Avenue<\/em>, Brookings (May 11, 2015), https:\/\/www.brookings.edu\/blog\/the-avenue\/2015\/05\/11\/good-fortune-dire-poverty-and-inequality-in-baltimore-an-american-story\/.<\/p>\n [13]<\/a> Housing cost and income estimates National Low Income Housing Coalition Out of Reach 2016 http:\/\/nlihc.org\/oor<\/a>.\u00a0 NLIHC uses HUD Fair Market Rents and a housing (rent and utilities) affordability cap of 30 percent of household income in its estimates.<\/p>\n [14]<\/a> Id<\/em>.<\/p>\n [15]<\/a> NPC Research, Baltimore City Drug Treatment Court (Adult Offenders in District Court) Process Evaluation Final Report<\/em>, 22 (2007), available at http:\/\/www.courts.state.md.us\/opsc\/dtc\/pdfs\/evaluationsreports\/balt_city_drug_treat_court_dist-adult.pdf.<\/p>\n [16]<\/a> See<\/em> NLIHC, supra <\/em>note 13.<\/p>\n [17]<\/a> See id.<\/em><\/p>\n [18]<\/a> http:\/\/housingforallbaltimore.org\/<\/a> (last visited Oct. 30, 2016).<\/p>\n [19]<\/a> See e.g.<\/em>, Pamela Wood, Baltimore County Council Rejects Housing Anti-discrimination Bill<\/em>, Baltimore Sun (Aug. 1, 2016), http:\/\/www.baltimoresun.com\/news\/maryland\/baltimore-county\/bs-md-co-housing-policy-vote-20160801-story.html.<\/p>\n [20]<\/a> See<\/em> Colin Campbell, Baltimore Will Vote on Affordable Housing Trust Fund in November<\/em>, Baltimore Sun (Aug. 29, 2016), http:\/\/www.baltimoresun.com\/news\/maryland\/baltimore-city\/politics\/bs-md-ci-housing-charter-amendment-20160829-story.html.<\/p>\n [21]<\/a> http:\/\/housingforallbaltimore.org\/<\/a>, supra<\/em> note 19.<\/p>\n","protected":false},"excerpt":{"rendered":" By Mary Stover, CFCC Student Fellow (2016-2017) On a recent Wednesday I, along with other CFCC Student Fellows, observed an uplifting morning in the Adult Drug Treatment Court at the Baltimore City District Court.\u00a0 At the conclusion of each of seven brief status hearings, the presiding judge, the Honorable Martin Dorsey, congratulated the compliant participant,…<\/p>\n","protected":false},"author":4169,"featured_media":762,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/posts\/758"}],"collection":[{"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/users\/4169"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/comments?post=758"}],"version-history":[{"count":1,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/posts\/758\/revisions"}],"predecessor-version":[{"id":1054,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/posts\/758\/revisions\/1054"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/media\/762"}],"wp:attachment":[{"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/media?parent=758"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/categories?post=758"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.ubalt.edu\/cfcc\/wp-json\/wp\/v2\/tags?post=758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}